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Fear of discrimination is a major concern for LGBT people in China when they have to access health care, with 61 percent of respondents in a new study on the status of LGBT health in China reporting that they are afraid of being treated differently by doctors because of their sexual orientation or gender identity.

Released from Beijing on Monday, the report showed that 46 percent of respondents had experienced discrimination from health care workers after their sexual orientation or gender identity was disclosed.

Su Qi, a 20-year-old transgender woman living in Guangzhou in southern China, told Sixth Tone that she hesitates whenever she needs to visit a hospital, fearing the discrimination she might encounter as a trans woman. “My ID card says that I’m male, so I feel like I can’t wear female outfits when I see a doctor,” Su said. She added that she didn’t see “transgender” as an option in the gender column when filling out a form for an HIV test in Guangzhou last year.

The report was based on a survey of 1,205 participants across 30 provinces in China, and was conducted by the nongovernmental organization Love Without Borders Foundation. It covers respondents’ awareness of health issues, including HIV, and experience using medical services. The report was sent to Sixth Tone via e-mail and is currently not available online.

“This is the first comprehensive study of the status of LGBT health in mainland China,” Liu Wenyuan, project officer at Beijing Love Without Borders, told Sixth Tone. She said that previous research had typically narrowed the scope of LGBT health to mental health issues, or to HIV and AIDS, or had covered only gay men and lesbians. At 87.2 percent, the majority of respondents in the study were gay or bisexual men, while lesbian and bisexual women made up only 12 percent. Fewer than 10 percent of respondents were transgender.

Though Chinese society has become more accepting of LGBT individuals in recent years due to increased media coverage and public visibility, sexual and gender minorities still find their rights to health care are not fully protected.

In October, China’s state council passed the Healthy China 2030 plan, which sets forward a blueprint for improving the quality and scale of the country’s health care system, as well as equity of access across urban and rural areas. But Kong Lingkun, the president of Love Without Borders, said it is essential for China to provide equal, fair, and effective services to its long-neglected LGBT population if the nation is to achieve its goals of “health for all.”

Many respondents indicated that they felt medical professionals in China lack awareness and understanding of LGBT people, with 27 percent reporting that they experienced “contempt and indifference” from health workers, while 18 percent stated that hospital staff had considered their gender identity or sexual orientation to be “a disease,” either through implication or explicit diagnosis.

Homosexuality was declassified as a mental illness in China in 2001, but gender identity disorder remains pathologized, both in China and internationally, though transgender advocates have called for it to be removed from the International Classification of Diseases.

Facing ignorance from medical professionals, 42 percent of respondents said that they do not disclose their sexual orientation or gender identity when seeing a doctor mainly because they “are afraid of being labeled,” “fear discrimination,” or “feel embarrassed,” while 36 percent said they would disclose these details if the medical issue was sex-related.

One gay man from southwestern Yunnan province was quoted in the report as saying that the medical workers in the district-level disease control and prevention center that he visited are blatantly homophobic and AIDS-phobic. “They asked, ‘Why are you here for testing? Did you engage in sexual behavior? Did you go whoring? And if so, we’ll call the police to arrest you,’” he said.